A former RCMP officer, “Maria” continued to experience severe and chronic pain from a hand injury incurred in the line of duty. She found some relief from the pain with the use of morphine tablets. “In the beginning, the side effects from morphine weren’t quite so bad,” she recalls. “But it seemed to get worse. Narcotics were altering my reality. They were altering everything about me.”

In a video profile of Maria produced by the licenced cannabis producer Tilray, Maria shares her experiences with pain and her journey to recovery. As the very first client of Tilray, a supplier of medical cannabis under the Access to Cannabis for Medical Purposes Regulations, she says her pain subsided for hours at a time without unpleasant side effects. “All of the pain just faded,” she says. “I’m not high, I’m not out there and I have no side effects. After eight weeks, I was free of morphine.”

The reality is, that on average, more than 10 Canadians die every day from an opioid overdose. “There were almost 4,000 apparent opioid-related deaths in Canada in 2017,” says Dr. Blake Pearson, a physician and founder of Greenly Medical Consulting in Sarnia, Ontario, which aims to educate patients, the public and fellow medical professionals on cannabinoid medicine. “That constitutes a national opioid crisis,” he says.

Philippe Lucas, Vice President of Global Patient Research and Access at Tilray, has no illusions that medical cannabis will completely replace opioids such as morphine. However, he believes that effective longitudinal studies and clinical trials will provide doctors with the information they need to determine when either opioids or medical cannabis are the best choice for addressing patient pain. The Tilray Observational Patient Study (TOPS), an observational study sponsored by Tilray, intends to address that research need.

According to Lucas, a graduate researcher with the Canadian Institute of Substance Use Research, there has been a significant amount of research on cannabis, but a lack of clinical trials. “That’s not surprising given that cannabis has been an illicit substance around the world for the past 70 to 80 years. There’s been difficulty in accessing a research-grade supply of cannabis and researchers have been presented with a number of legal hoops they have to jump through to devise studies looking at benefits of cannabis rather than harm. Alongside gradual legalization, there’s been a real renaissance of research and Tilray has been one of the companies leading that charge by shining the light into formerly dark corners.”

Tilray has initiated clinical studies on post-traumatic stress disorder, chronic obstructive pulmonary disease, and chemotherapy-induced nausea and vomiting. The company also recently concluded a clinical study on the treatment of seizures in pediatric epilepsy.

TOPS, a multi-site examination taking place in over 20 medical clinics in 5 provinces, is designed to track the impact of medical cannabis on opioid use and other prescription drug use, and quality of life among 1,700 patients across Canada. Lucas believes this is an important area of research, noting that according to statistics from the World Health Organization, Canadians are the second-highest per capita users of opioids in the world.

Preliminary results are encouraging, showing significantly less opioid use amongst those using medical cannabis, according to Lucas, “the high rate of cannabis use for the treatment of chronic pain — and subsequent substitution for opioids — suggests that cannabis may play a harm-reduction role in the ongoing opioid dependence and overdose crisis,” he says. “Opioids are very powerful analgesics to address severe chronic pain, but we believe physicians should have access to a full tool kit to treat pain conditions. In light of growing research establishing the relative efficacy and safety of medical cannabis, its current placement as a third-line treatment option may not fully recognize its potential to curtail the opioid epidemic. Given the preliminary results of the TOPS study and similar research in the US and internationally, it doesn’t appear to make sense that a patient should have to fail out of opioid treatment before they try cannabis.”

“One of the biggest barriers for patients in accessing medical cannabis is that medical professionals are not comfortable in prescribing it,” says Dr. Pearson, whose clinic is also participating in the TOPS study. “They’re not necessarily against it, but the endocannabinoid system isn’t part of most medical and nursing school curricula, and therapeutic cannabis isn’t supported by the volume of clinical trials and other longitudinal studies that would make them more comfortable in prescribing it—although the body of conclusive evidence is certainly growing.”

According to Dr. Pearson, “Medically prescribed opioids have their place in managing pain, especially when it comes to acute pain. But data from the TOPS study may be able to help move medical cannabis from a third-line treatment to a second-line treatment for the management of neuropathic pain, alongside, or even ahead of opioids, given its lower risk of dependence and harm. By providing solid research data to the medical community, we hope to see medical cannabis deliver on its potential to reduce the number of opioid-related fatalities.”

“While cannabis itself will not put an end to the current opioid overdose crisis” says Lucas, “a growing amount of evidence from Canada and the US suggests that it can reduce the therapeutic use of opioids and associated morbidity and mortality by providing patients and physicians with a potentially safer alternative in the treatment of chronic pain. Ironically, rather than being a “gateway drug” as many of us were taught in school so many years ago, for many patients affected by chronic pain, cannabis may turn out to be an exit drug to problematic substance use.”

For more information on medical cannabis as a treatment option, and to find a clinic in your area, visit tilray.ca/find-a-clinic

This story was created by Content Works, Postmedia’s commercial content division, on behalf of Tilray

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